Active NPI
Tyrone Farias, PA
- Physician Assistant
- Palm Beach Gardens, FL
National Provider Identifier
1245208776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9103022
- Practice address
- 3370 Burns Rd Ste 105
Palm Beach Gardens, FL 33410-4327 - Phone
- (561) 630-3570
- Fax
- (561) 630-8572
- NPI assigned
- Mar 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9103022 | FL | Primary |
Addresses
Primary practice location
3370 Burns Rd Ste 105
Palm Beach Gardens, FL 33410-4327
Mailing address
PO Box 863481
Orlando, FL 32886-3481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9103022 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189123200000",
"number": "1245208776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 863481",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328863481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3370 BURNS RD STE 105",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334104327",
"telephone_number": "561-630-3570",
"fax_number": "561-630-8572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARIAS",
"first_name": "TYRONE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2007-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9103022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.